May 4, 2012

Massachusetts Nursing Home Abuse Case Results In $250,000 Settlement

File this case under “Be careful what nursing home you choose for your loved ones.”

Here’s the story. An 82-year-old woman, who was confined to a wheelchair, and also had advanced dementia and impaired decision-making abilities, was admitted to a nursing home for care.

While there, staff members became increasingly suspicious that the woman was receiving inappropriate physical contact from a younger male resident. Some witnessed the young man touching her and having inappropriate physical contact with her. However, staff members who witnessed the improprieties were allegedly told to literally “keep their eyes shut.” As it turns out, the young male resident sexually molested the woman on several occasions.

Ultimately, law enforcement was notified and the male resident admitted to inappropriately touching the woman on numerous occasions.

This Massachusetts nursing home abuse case settled for $250,000.

As a Dedham Massachusetts nursing home abuse attorney, I can safely say that nursing home abuse represents one of the fastest-growing areas of Massachusetts personal injury litigation. Why, you might ask? There are two main reasons. First is the increased number of nursing home residents, due to longer life spans of the average American. Second is the fact that many nursing homes are owned by large corporations, which care more about the “bottom line” of profitability, than they do patient care. When a nursing home cautions its workers to “keep their eyes shut,” as they allegedly did in this case, it makes a strong statement how corporations keep their on the bottom line, more than anything else. I've blogged about this before. Sadly, it is a theme that repeats itself far too often.

April 25, 2012

Massachusetts Nursing Home Abuse Can Go To Jury, Not Arbitration

If you have placed someone that you love in a nursing home, signed a healthcare proxy on their behalf, and later decide you want to sue in court for Massachusetts nursing home abuse , or file a Massachusetts wrongful death suit, this blog post is for you. That's because many Massachusetts nursing home contracts require the patient or the patient's representative to submit to binding arbitration (outside of court) in the event of a legal dispute, instead of allowing the plaintiff to file a lawsuit in court, and argue his or her case to a jury. These are known as "binding arbitration clauses." Are they always valid? No.

A recent court decision in Massachusetts illustrates that in some cases, these binding arbitration clauses in nursing home contracts can be defeated, allowing a plaintiff to bring his or her case in court, to a jury. This is important, because most nursing homes compel you to go to binding arbitration, waiving the right to a jury trial.

Here’s a brief version of the case that defeated such a nursing home binding arbitration clause. A man named Salvatore Licata admitted his mother to a hospital, as she was suffering from Alzheimer's-type dementia. On the day after the hospital admission, Licata’s mother, Rita, signed a Massachusetts Healthcare Proxy appointing her son as her healthcare agent, with the authority to make all healthcare decisions for her, should a physician determine that she lacked the capacity to do so on her own.

Four days later Rita was discharged and transferred to a nursing home. At the nursing home intake meeting, Mr. Licata filled out all of the necessary paperwork, saying, however, that he didn’t fully understand all of the papers. As part of that process, he signed a two-page agreement in which Rita had agreed that if there was any future claim against the nursing home, for negligence or otherwise, that the matter would go to out-of-court arbitration and not to court. In 2009 Rita died. Mr. Licata believed her death was a result of Massachusetts nursing home negligence, and filed a wrongful death suit.

A Superior Court judge has ruled that since Mr. Licata signed a healthcare proxy – and not a “Power of Attorney,” which is a different type of document – it would not bar his wrongful death suit against the facility. What this means is that he is not compelled to submit to arbitration, outside of court. He can, in fact, have a jury trial for his Massachusetts wrongful death lawsuit. A Superior Court judge found that the proxy was not properly activated at the time, and that even if it was, that Mr. Licata still lacked the authority to waive his mother’s right to a jury trial.

So if you should find yourself in a position where you wish to sue a nursing home, there is hope for your case.

As a Massachusetts nursing home abuse attorney, I can also tell you this: Nursing home abuse is one of the fastest-growing areas of Massachusetts personal injury litigation. There are two reasons why. First, there is an ever-increasing number of nursing home residents, due to average Americans having a longer lifespan. Second, many nursing homes are owned by large corporate organizations, who care more about the “bottom line” of profitability, than they do patient care.

The right of civil jury trial is one of the most important civil legal rights that we have, and this very correct decision underscores that point.

August 2, 2011

Study Shows Nursing Home Patients Suffer Increased Risk of Falls After Taking SSRI’s.

Scientists at the Institute for Aging Research at Hebrew SeniorLife in Boston, Massachusetts released a study today that indicates that nursing home patients who are given SSRI antidepressants are at increased risk of suffering falls. SSRI’s are a class of anti-depressants known as Selective Serotonin Reuptake Inhibitors, which in general act to increase levels of serotonin in the brain. Common names for these drugs include Prozac, Paxil, Lexapro, Celexa, and Zoloft.

The study, published in the Journal of Gerontology: Medical Sciences, examined 1,181 cases of nursing home falls. The study reportedly discovered a five-fold increase in patient falls within 48 hours of receiving a new SSRI, or being administered higher doses of an existing SSRI that they were already taking. However, the rate appeared to decrease each day after the prescription change. In a press release, Dr. Sarah D. Berry, a scientist at the Institute for Aging Research of Hebrew Senior Life and the lead author of the study, said that “Our results identify the days following a new prescription or increased dose of a non-SSRI antidepressant as a window of time associated with a particularly high risk of falling among nursing home residents." Berry theorized that the increased risk of falling after receiving an SSRI might be due to coordination problems caused by the medications. Berry commented that the benefits of these medications may still outweigh the increased risk of falling, so long as patients are closely monitored in the days immediately following administration of the drugs.

These findings are important because far too many nursing home patients are prescribed antidepressants, because they exhibit symptoms of depression. Ask yourself: What nursing home resident have you ever met who wouldn’t have reason to be depressed? If the average American knew what life (or more accurately, “existence,”) was really like in a nursing home, they’d be shocked. The response of most Primary Care Physicians and nursing home medical directors to dealing with the predictable depression that results when a patient is placed in a nursing home, is to put the patients on yet another medication – antidepressants. This practice has even increased in the recent past, now that medical studies have proven that administering anti-psychotic medications to nursing home residents suffering from dementia produces an increased risk of death to patients suffering from dementia. For years, patients suffering from senility and Alzheimer’s Disease were routinely prescribed anti-psychotics, due to the symptoms the disease would cause. Finally, medical studies proved that giving anti-psychotic medications to dementia patients could be fatal, so doctors switched over to prescribing these same patients antidepressants. Now, new research shows that antidepressants can cause elderly patients to lose their balance and suffer debilitating falls.

All this illustrates a broader, and far more important point: Too many nursing home medical staffs just throw darts when it comes to treating patients: They aren’t really sure that a given medication will help a patient, but then again they aren’t sure – so they reach for almost any psychoactive medication that will help “keep the patient quiet.” And the irony is that such a generalized, non-specific approach only increases the nursing home operator’s liability exposure – as prescribing antidepressants to seniors will do, if the effect is to make injuries from falls that much more likely. But that doesn’t seem to stop them.

As a Dedham Massachusetts nursing home abuse lawyer, I can assure my readers: If you have a loved one who is in a nursing home, make yourself known to the staff as someone who is there on a regular basis – and as someone who is always watching. Don’t ever stop making regular visits to your loved one – and make it clear when you are there, that you are watching everything in relation to the care (and medication management) of the patient. Otherwise, if you visit rarely or infrequently, the staff will come to know that – and the care and attention that your loved one receives will very likely drop down on their list of priorities. That’s one of those things that no nursing home administrator or owner will ever admit, but it’s true.

If a relative or someone you care about is in a nursing home and you suspect that he or she may be a victim of neglect or abuse, contact us for a free consultation. We are experts in this complex area of law, and can give you the advice you need.

July 12, 2011

Massachusetts Nursing Home Abuse: Keep Watchful

Nursing home abuse and neglect is, tragically, still a “dirty little secret” for most of society. While public consciousness has been raised in the past two decades due to the efforts of plaintiffs’ tort lawyers and brave families, I don’t think enough people, or enough media, truly appreciate just how pervasive this problem really is. Massachusetts nursing home abuse and neglect (and nursing home abuse that occurs everywhere) is caused by the willingness of far too many nursing home companies, to allow the safety and well-being of their paying residents to suffer, in the name of maximizing their profits.

Making matters worse, corporations that own nursing homes in Massachusetts still cannot be held criminally responsible for the acts of their employees. Note: I am talking here about a corporation being held responsible for criminal acts, not specific individuals. While a specifically named nursing home employee who is accused of committing a criminal act against a nursing home resident, such as an assault and battery, can be criminally convicted, the corporation still, as of this time, cannot be.

In my view as a Norfolk County Massachusetts nursing home abuse lawyer, that itself ought to be a crime. The Massachusetts Attorney General tried to change that law in a novel criminal indictment a few years ago. Sadly, that noble effort did not succeed. The indictment charged a parent corporation that owned a nursing home with involuntary manslaughter and criminal neglect, based on its collective knowledge of the conduct of several of the corporation's employees. What made the case novel was that the indictment did not single out any one employee of the corporation for criminal acts -- instead, the corporation itself was indicted. This legal approach to indicting a corporation for the criminal acts of its unnamed employees, had never before succeeded. The case was Commonwealth of Massachusetts vs. Life Care Centers of America. This case represented the first attempt by the state of Massachusetts to criminally indict a corporation for manslaughter and neglect in the death of a nursing home resident.

The case held the promise of prosecuting and convicting a corporation for such offenses, and sadly it was struck down last year by the Supreme Judicial Court. This decision destroyed the promise of producing drastically positive changes and improvements in the care and protection of Massachusetts nursing home residents. Trust me, had the Attormey General's office prevailed, the decision would have caused these businesses to take immediate steps to make certain that Massachusetts nursing home abuse and neglect no longer occurred under their ownership. Plaintiffs’ lawyers bar associations such as The American Association for Justice (formerly the American Trial Lawyers Association/ATLA,) and its Massachusetts affiliate, the Massachusetts Academy of Trial Attorneys (MATA,) are working hard to change these laws. For now, plaintiffs tort lawyers like me will continue to hold nursing home owners civilly liable for any harm caused by their employees, to these most vulnerable of people: Old, weak, senile, abandoned, and defenseless victims - the forgotten of society.

Remember: As with the ability to legally recover for many other types of injuries, “tort reform” would severely limit, or entirely prevent, the ability to hold a corporation civilly liable for their negligence, and require them to pay appropriate damages. Insurance companies, and their business customers, want to take away your right to a jury trial - your day in court. If you want to learn more about tort reform, go the the Search field on the right side of this page, and type in "tort reform." You'll be taken to a number of posts I've written on the subject.

In the meantime, if you need to place a loved one in a nursing home, exercise great caution in the facility you choose. Do NOT just ask for references from the nursing home itself – find out the names of present or past family members of residents of the facility, and quietly speak to them about their experiences with the facility. Check out internet postings. Review any complaints filed with the Massachusetts Executive Office of Elder Affairs or the Massachusetts Department of Public Health. Below are some additional governmental resources you can refer to, to report nursing home abuse or neglect.

* State Long Term Care Ombudsman & Adult Protective Services
Massachusetts Exec Office of Elder Affairs
1 Ashburton Place, 5th Floor
Boston, MA 02108-1518

Phone: (617) 727-7750
Fax: (617) 727-9368
website: www.mass.gov


* Director of Licensure and Certifications
Massachusetts Department of Public Health
Division Health Care Quality
10 West Street, 5th Floor
Boston, MA 02111

Phone: (617) 573-1600
website: www.mass.gov

* Medicaid Fraud Control Unit of Massachusetts
Office of the Attorney General
200 Portland Street, 4th Floor
Boston, MA 02114-1700

Phone: (617) 727-2200
Fax: (617) 727-2008
www.mass.gov

* Board of Registration In Nursing Home Administrators
239 Causeway Street
Boston, MA 02114

Phone:1-800-414-0168
Fax: (617) 973-0980
website: www.mass.gov

* Commissioner,
Massachusetts Division of Medical Assistance
600 Washington Street
Boston, MA 02111

Phone: (617) 573-1770
www.mass.gov

* Quality Improvement Organization:
President/Chief Executive Officer
Mass PRO
245 Wyman Street
Waltham, MA 02451-1231

Phone: (781) 890-0011
website: www.masspro.org

* Protection and Advocacy:
Executive Director
Disability Law Center, Inc.
11 Beacon Street, Suite 925
Boston, MA 02108

Phone: (617) 723-8455
website: www.dlc-ma.org

* Citizen Advocacy Group:
MA Advocates for Nursing Home Reform
P.O. Box 560224
Medford, MA 02156

Phone: 1- (800) 988-4450
website: www.manhr.org

At any time, if you suspect that either a loved one, or someone you know, has been the victim of Massachusetts nursing home abuse or neglect, contact our office for a free consultation. We will be happy to provide you with the direction you need to protect the person you are concerned about. It's what we do. And we do it very well.

May 30, 2010

Small Firm Proves Nursing Home Negligence Will Be Punished: $29 Million Verdict

My regrets over not having posted for awhile here, but let’s get back to things today:

Normally, as this is blog is about Massachusetts personal injury cases and Massachusetts tort law, I write about plaintiffs’ civil justice issues occurring primarily in this state. However, a recent case verdict out of the state of California offers some instructive points on how personal injury plaintiffs can achieve far better legal and financial results with a small firm, than with a large law firm. On this very point, by the way, visit the “About The Firm“ tab at my web site Home Page. See the article. "The Urge To Merge: Bad News." I think you’ll find it interesting.

Two small plaintiffs’ law firms in California teamed up to obtain a $29 Million verdict against a corporation who operates a chain of 33 nursing homes across California and Utah, “Horizons West,” in an all-too-familiar case of nursing home negligence and abuse. The plaintiff was the estate of a 79 year-old woman, an Alzheimer’s Disease patient, who died after not receiving prompt medical treatment for eight days after she fell and fractured her hip. Aside from that untreated injury, the patient also developed a bed sore during those eight days, which was also listed as a cause of death on her death certificate. The plaintiffs’ lawyers, both essentially solo practitioners, alleged that the defendant nursing home intentionally understaffed the facility, or kept it at a bare minimum relative to the number of patients residing there, all to maximize its profits. Any surprise there? I’ve been writing and speaking about how corporations do this to consumers, patients, and all kinds of people, for over 20 years now. (If anyone still doubts that, take a look at my last post about BP and the Gulf oil spill.)

The plaintiffs’ lawyers who deserve the credit for this victory are attorney Edward Dudensing, principal of a two-lawyer firm in Sacramento, California, and attorney Jay Renneisen, founder of a two-lawyer firm in Walnut Creek, California. These two very small firm lawyers convinced the jury in this case that this nursing home operator intentionally and chronically understaffed their facilities, and that the owner of these facilities engaged in a corporate scheme that siphoned profits to another corporate entity, while giving the accounting appearance that the facility being sued, had essentially no assets. This is a common legal ploy with businesses that are sued: Set up a corporation separate from the corporate defendant being sued; give it a different name, different address, different staffing, different corporate officers and board of directors, different tax ID numbers. Discreetly siphon off funds from the primary corporate defendant, to that 2nd corporation, and essentially claim that the defendant corporation that is being sued is bankrupt and “judgment-proof”, to quote the legal term.

Thankfully, this scheme didn’t work here, because there happens to be another legal term known as “Piercing the corporate veil.” This occurs when a party (usually a plaintiff) successfully demonstrates to a court that the additional corporation is essentially what is legally known as an “alter ego” of the allegedly bankrupt defendant. In this case, these two talented small law firms were able to prove to the jury, that the defendant corporation was anything but devoid of assets, and that the secondary corporation was legally liable for the torts of the named primary defendant. According to Jay Renneisen, one of the plaintiffs’ two lawyers, “We were able to show how all the profits and assets floated up to the top (of the secondary corporation,) and all the liabilities were saddled on [the original corporate defendant], effectively leaving the defendant with no assets.” One particular trick the primary defendant tried, was to purchase a (liability) insurance policy for $1 million with a $1 million deductible, essentially yielding zero coverage. Making matters even worse, was that a $100,000 premium was paid to an insurance company owned by the parent of the “real” corporate defendant. This translates to the owners of this defendant essentially getting paid for lying (by collecting the “insurance” premium.) All this came into play (though not exclusively) in the jury’s award of punitive damages here.

There were far more egregious reasons to punish these defendants, than the assets manipulation and "alter ego" corporate scheme that they engaged in. The defendant corporation, Horizons West, was shown to have delayed the diagnosis and treatment of this 79-year-old Alzheimer’s patient, for eight days after she fractured her hip in a fall. As stated above, during that delay in treatment, she was left in a bed and developed a bed sore that also contributed to her death. At trial, the plaintiffs’ lawyers argued that the facility intentionally under-budgeted for staff, for the sole purpose of maximizing net income. Documents introduced at trial showed that the same day that the patient fell, the nursing home was given and acknowledged a “deficiency citation” from the state department of health, for assigning staff below what would be needed to provide the state-mandated 3.2 nursing hours for each patient per day. Just how bad was the staffing? Discovery showed the defendant employed 24 accountants for the company’s books, and only three nurses for the patients.

The facility intentionally reduced staffing, (including the day the patient fell and broke her hip,) to avoid paying staff overtime, the plaintiffs’ attorneys showed. Evidence at trial established that the facility put only one licensed nurse on duty for over 40 Alzheimer’s and dementia patients. The plaintiffs’ lawyers produced a former employee at the nursing home, a certified nursing assistant, who broke down in tears as she testified that the reason she quit the facility, was because she felt the patients were not getting the amount of type of care they needed. I’ve always been convinced that demonstrative evidence is among the most powerful types of evidence to use before juries and judges (aside from documentary evidence.) In this case, the plaintiffs’ lawyers took a page out of my playbook and taped all of their depositions. They then had these videos at the ready at trial, and used those videotaped depositions to expose contradictions and inconsistencies in witness testimony.

For example, in one witness’ in-court testimony, a nurse testified that she remembered repositioning the patient to relieve her bedsore, even though there was no notation in any medical records of turning or repositioning the patient. Cue the lights: The plaintiffs’ lawyers then played for the jury this same witness’ prior videotaped deposition testimony, where this nurse not only said that she couldn’t recall whether she had repositioned the plaintiff or not, but also appeared annoyed in the deposition that she would be even expected to recall any events that occurred five years earlier. The effect this contrast had on the jury? “One juror said that (deposition video) was the last thing left in his mind when they went into deliberations,” according to Edward Dudensing, one of the two plaintiffs’ lawyers. Great legal work.

In the end, the jury was so outraged that it ignored the plaintiffs’ request for $10 million in punitive damages and instead nearly tripled that amount to $28 million.

So let this case send two messages: One, that Massachusetts juries as just as smart as California juries, and when juries learn the truth about Massachusetts nursing home neglect and abuse, they will punish corporate defendants severely; and two: That by no means does it take a “major law firm” to get superior legal results. Most major or large law firms I know of would not have had either the agility or creativity to accomplish what these two independent lawyers did here. I operate my law firm the same way, which is why we get the superior results that we do, and why I admire these two lawyers' results here.

To analogize: If you had to choose, which would you rather have fighting for you in court: A swift, agile Bobcat, or a large, lumbering hippo?

April 26, 2010

Massachusetts Nursing Home Kickback Scheme Lands Johnson & Johnson In Federal Court - PAa 2 of 2

In my previous post, I reported on the fact that Johnson & Johnson has been dragged into court by the United States Attorney in Boston, accused of hatching an elaborate scheme to press nursing home doctors to prescribe J&J’s anti-psychotic drugs, including Risperdal, to Massachusetts nursing home residents who were not suffering from mental illness or psychosis, but only dementia. Critically, it is widely known in the medical and geriatric care communities that the use of anti-psychotic medications in patients suffering from dementia, doubles the risk of death. The “marketing” scheme was a twisted effort by J&J to increase sales of their anti-psychosis drugs even higher than the $100 million in annual sales they were previously enjoying.

Antipsychotics were approved by the U.S. Food and Drug Administration (FDA) to treat people with severe mental illness – such as schizophrenia. While many of these medications have brought relief to severely mentally ill patients, and while they have their valid place in medical practice, in general they produce horrible side-effects. These unavoidable side effects include:

Dystonia - A neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. Essentially, this condition can reduce someone to an involuntary mass of body spasms, or twist you into distorted postures.
Parkinsonism – Muscle rigidity and muscle tremors; Essentially, this can reduce the body or parts of it, to being as stiff as a board.
Akathisia - A syndrome characterized by unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless. This condition can produce symptoms ranging from anxiety, to a complete inability to still or stand still.
Tardive dyskinesia, A condition in which the sufferer may show repetitive, involuntary, purposeless movements often of the lips, face, legs, or torso. These involuntary, purposeless movements usually occur in the face and lips, reducing someone’s expression to a mass of jerking tics.
Pancreatitis – An extremely painful and emiserating condition, leaving one’s midsection enflamed, swollen, and producing severe fevers.
Seizures – Causing patients to be constantly exposed to horrid and frightening neurological attacks, never knowing when the next one is to come – not to mention the brain damage that can result from seizures.
Diabetes – Placing patients at risk of losing their limbs due to amputations often necessitated by the disease.
Neuroleptic malignant syndrome, in which the body’s temperature regulation centers fail, resulting in a medical emergency, as the patient's temperature suddenly increases to dangerous levels. Essentially, the patient is subjected to sudden, high-grade fevers that are usually witnessed in the worst if influenza infections.

The list of these well-known side effects goes on and on. Now you know why it’s widely estimated that approximately two-thirds of mentally ill patients who are prescribed many anti-psychotics, stop taking them: They’re known as the “Treatment that’s worse than the disease.” And all of the above side-effects, and more, pale in comparison to the most widely-known side-effect of these drugs: That when given to patients suffering from dementia, they double the risk of premature death.

So how were J&J, and their criminal co-conspirator OmniCare, able to do this? Because as with many drugs approved by the FDA to treat specific illnesses and conditions, it is nonetheless legal for doctors to prescribe drugs, including anti-psychotics, “off-label” for other purposes. While that practice may be strictly legal when engaged in by individual doctors with individual patients, J&J engaged in a widespread, full-blown campaign to aggressively market their drugs to nursing homes as being appropriate, even desirable, for use with patients not suffering from mental illness, but merely dementia. Under J&J’s and OmniCare’s scheme, J&J quietly (and illegally) paid OmniCare millions in kickbacks to push these drugs to nursing home doctors. Once OmniCare sold these antipsychotics to nursing homes, it actually then filed for reimbursement from Medicaid for purchasing these drugs from J&J. Medicaid is the joint federal-state health care program for the poor – which pays for nursing home care for many poor seniors.

I trust you see the added hook here for OmniCare – not only did this scheme allow them to grossly increase their sales of these anti-psychotic drugs to nursing homes, but the fact that they were selling to nursing homes that cared for many poor elderly patients, allowed OmniCare to then bill Medicaid for the cost of buying these drugs from J&J in the first place, (who also paid OmniCare kickbacks for purchasing the drugs from them.) End result: J&J, the drug manufacturer, massively increased sales of their anti-psychotic drugs to their distributor, OmniCare (from $100 million to $280 million.) OmniCare received millions of dollars in kickbacks from J&J on the front end, for buying higher amounts of these drugs from J&J, and then OmniCare illegally billed Medicaid on the back end for reimbursement of the cost of purchasing the drugs from J&J, since the drugs were administered to low-income or indigent nursing home residents.

And the thousands of powerless Massachusetts nursing home residents who were needlessly pumped full of these mind-altering anti-psychotic drugs? There were less than nothing; an afterthought in this twisted scheme. As to just how many Massachusetts nursing home residents were victimized in the process of bloating both J&J and OmniCare’s profits, consider this: The Massachusetts Attorney General reported that a whopping 28 per cent of Massachusetts nursing home residents were given these anti-psychotic drugs, last year alone. Of that figure, 22 per cent were not mentally ill or did not have a medical condition that warranted such extreme treatment. This rate was the 12th highest in the nation.

Pretty sick, isn’t it? Yet nothing new for huge corporations like this.

This sad and sick story illustrates two key points: 1) Massachusetts nursing home abuse and neglect is rampant – far more common than most people can imagine – and it’s not always committed by a cruel or thoughtless health aide, acting alone. In this case, the abuse was actually aided and abetted by nursing home doctors who didn’t question either J&J’s or their distributor’s (OmniCare’s) claims about the use of these anti-psychotic drugs with patients who were not suffering from mental illness or psychosis. 2) This twisted story illustrates how Massachusetts and the rest of this country must remain vigilantly opposed to big business and corporate efforts to enact “tort reform”. As I’ve said before, “tort reform” is nothing more or less than an effort to re-write liability laws, to allow big business and others to commit wrongdoing, and be shielded from the lawsuits that would hold them accountable. Thankfully, we haven’t reached that stage yet in Massachusetts, which is one reason why nursing homes and their doctors will think twice about engaging in such irresponsible and unethical conduct in the future: Because they’ll pay in court if they don’t.

Continue reading "Massachusetts Nursing Home Kickback Scheme Lands Johnson & Johnson In Federal Court - PAa 2 of 2" »

April 22, 2010

Massachusetts Joins U.S. Attorney In Accusing Johnson& Johnson of Kickback Scheme With Nursing Homes – Part 1 of 2

This case is filed under “Nursing Home Abuse and Neglect” on this blog for a good reason: That’s exactly what it is – except that the abuse wasn’t committed by a lone employee of a single nursing home, who ended up abusing patients. It was committed by a conspiracy among a multi-billion dollar pharmaceutical firm, dozens of separate nursing homes, and doctors and nurses also. If true (and to date, I see little evidentiary reason not to believe the allegations) it is a sickening story of corporate and individual greed, compounded by some of the worst examples of human cruelty to the most frail and forgotten members of society – nursing home residents.

By all credible accounts, the story seems to have unfolded as follows: Pharmaceutical giant Johnson & Johnson apparently paid tens of millions of dollars to a firm called OmniCare, which although most people have never heard of, happens to be the nation’s largest provider of pharmaceutical drugs to nursing homes. The illicit payments were designed specifically to entice and assure that the company (OmniCare) aggressively and intensively pushed several of its drugs, particularly the powerful antipsychotic drug Risperdal, to nursing home doctors, using aggressive rebate programs and other financial incentives. The scheme is alleged to have lasted from 1999 to 2004. What’s the problem with that, one might ask – don’t some nursing homes need antipsychotic medications? Yes, but the twisted cruelty and malignancy here, is that Johnson & Johnson and OmniCare aggressively waged a campaign with nursing homes and their doctors to prescribe antipsychotics such as Risperdal, to patients suffering from dementianot psychosis. J&J marketed their antipsychotics as a legitimate, valid medication to “sedate and control” patients suffering from dementia, when it was originally designed and approved to treat severe mental illness.

That twisted marketing campaign resulted in J&J nearly tripling sales of its antipsychotic drugs to OmniCare, from approximately $100 million just before the scheme began, to in excess of $280 million when the operation was discovered by government investigators in 2004. Imagine - - $100 million in sales (of these drugs alone) was not enough for J&J: They concocted this twisted scheme to fatten their profits even more, all the while risking the health and lives of tens of thousands of helpless nursing home patients. It is well- known in the medical profession that prescribing antipsychotics to patients suffering from dementia more than doubles their risk of death due to these medications. But that didn't phase J&J, nor OmniCare, in their insatiable quest for more profits.

Before anyone thinks that dementia and psychosis are similar, let me assure readers of this blog, as someone who is very familiar with nursing home practices and medical issues related to dementia, that dementia and psychosis are completely, totally different illnesses, and to deliberately try to lump them together and push these mind-altering drugs into a population that is least capable of defending themselves, and doubling their risk of death, is beyond sick. It is among the most disgusting stories of corporate greed I have encountered in my legal career. Yet, it is nothing new for corporate America: The crazed drive for greed and financial gain at any cost to human life and human dignity, controls so much of corporate America. It has, for so long. If anyone doubts this, think of these names: Ford Pinto, The Dalkon Shield, Philip Morris, W.R. Grace, Lehman Brothers, AIG, Goldman Sachs, the banking industry, the insurance industry, Toyota, on and on. It never seems to end. I’ll provide more details on this elaborate corporate scheme, in my next post.